HONG KONG — A survey released on Sunday by three leading respiratory health organizations showed that approximately seven out of 10 Hong Kong residents lack sufficient knowledge about chronic obstructive pulmonary disease (COPD) and asthma, raising concerns about delayed diagnosis and poor disease management.

The “New Breakthroughs in Respiratory Medicine – Awareness and Misconceptions” survey was conducted online from Feb 27 to May 26 this year by the Hong Kong Lung Foundation, Hong Kong Thoracic Society, and CHEST Delegation Hong Kong and Macau.

The findings from the survey interviews with 1,403 respondents across different age groups, genders and educational backgrounds revealed troubling gaps in public understanding of some of the city’s most deadly diseases.

COPD affects 25.9 percent of Hong Kong adults aged 60 and above — meaning one in four elderly residents lives with the condition. It ranks among Hong Kong’s top ten killer diseases, causing more than a thousand deaths annually, said Lam Chi-leung, David, vice-chairman of the Hong Kong Lung Foundation.

Asthma also affects a significant number of people, with an estimated 330,000 to 400,000 residents living with the medical condition in Hong Kong.

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Despite these alarming figures, 67.6 percent of respondents said they lacked adequate understanding of both diseases. More than 32 percent mistakenly believed COPD and asthma share identical symptoms and pathology.

In reality, asthma is caused by airway inflammation and hypersensitivity, and symptoms can usually be controlled with proper treatment. COPD, by contrast, is characterized by persistent and progressively worsening airflow limitation accompanied by lung tissue damage.

Nearly 26.4 percent of respondents held the misconception that patients with either condition should rest more and exercise less because of breathlessness, said Lam, adding that this belief was counterproductive.

“If patients avoid exercising entirely due to shortness of breath, it will lead to physical deconditioning, muscle weakness and increased breathing difficulties, creating a vicious cycle,” he said.

Asthma not just a childhood disease

The survey also found that 8.6 percent of respondents incorrectly believed that asthma is a disease exclusive to children, even though it can develop at any age.

In addition, 42.3 percent wrongly thought that asthma medications — particularly inhaled steroids — could cause serious side effects such as osteoporosis or addiction, and should only be used during attacks. Another 34.9 percent believed that once symptoms such as coughing or wheezing subside, patients are cured and can stop medication.

Experts said all three misconceptions are dangerous because they can lead to under-treatment and worsening disease outcomes.

Lung cancer treatment misunderstandings

Lui Mei-sze, president of the Hong Kong Thoracic Society, noted that lung cancer remains as Hong Kong’s leading cancer killer, claiming nearly 4,000 lives annually — more than 26 percent of all cancer deaths. However, the survey found that nearly 60 percent of respondents harbor misconceptions about lung cancer treatment.

While 41.8 percent correctly identified surgical resection as the primary treatment for early-stage lung cancer, 19.9 percent mistakenly believed immunotherapy could cure early-stage lung cancer. Nearly 18 percent thought targeted therapy applies to all lung cancer patients, while 20.7 percent believed end-stage lung cancer is untreatable.

Lui emphasized that targeted therapy and immunotherapy are precisely the options available for treating advanced lung cancer, and urged patients not to lose hope. “With new breakthroughs in respiratory medicine, a proper understanding of the prevention and treatment of lung cancer is a crucial weapon in combating it,” she said.

Misidentified pulmonary fibrosis symptoms

Wong Wai Yin, president of the CHEST Delegation Hong Kong and Macau, expressed concern that pulmonary fibrosis — a highly fatal disease that can progress even faster than most cancers — remains poorly understood by the public.

The survey found that 57.3 percent of respondents misidentified its symptoms, including 28.4 percent who did not recognize “clubbed fingers” (fingertips becoming rounded like drumsticks) as a physical sign of idiopathic pulmonary fibrosis. Meanwhile, 17.1 percent failed to identify “shortness of breath during activity,” and 11.8 percent did not recognize “chronic dry cough”, as common symptoms.

Misleading flu vaccine myths persist

When asked about contraindications for the influenza vaccine, more than half of respondents answered incorrectly.

The survey also found that 26.3 percent mistakenly believed people with egg allergies should avoid vaccination; 23.2 percent thought pregnant women should not receive the shot to avoid affecting the fetus; and 5.2 percent believed that getting a flu shot last year provides immunity this year. Only 45.3 percent correctly identified that infants under six months old should not receive the vaccine.

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Wong clarified that the flu vaccine given to pregnant women in Hong Kong is primarily the inactivated influenza vaccine, which contains killed viruses. “A vast amount of medical data proves that it does not cause fetal malformations and is safe to administer during any stage of pregnancy, including the first trimester,” she said.